Journal Article

Pharmacokinetics of Antimycobacterial Drugs in Patients with Tuberculosis, AIDS, and Diarrhea

Shurjeel H. Choudhri, Mark Hawken, Samuel Gathua, George O. Minyiri, William Watkins, Jan Sahai, Daniel S. Sitar, Fred Y. Aoki and Richard Long

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 1, pages 104-111
Published in print July 1997 | ISSN: 1058-4838
Published online July 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514513
Pharmacokinetics of Antimycobacterial Drugs in Patients with Tuberculosis, AIDS, and Diarrhea

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To test the hypothesis that antituberculous drug disposition is altered in patients with AIDS, we studied the steady-state pharmacokinetics of isoniazid (300 mg/d), rifampin (600 mg/d), and pyrazinamide (1,500 mg/d) in 29 adults (14 patients infected with human immunodeficiency virus [HIV] and 15 non-HIV-infected patients) with tuberculosis in Nairobi, Kenya. Intestinal integrity was assessed with xylose. Neither HIV infection nor diarrhea accounted for the interpatient variability in the area-under-the-plasma concentration vs. time curve (AUC), the maximum concentration, or the terminal half-life (t1/2) of isoniazid, rifampin, and pyrazinamide. No significant association between HIV infection or diarrhea and pharmacokinetics was seen for any of the compounds. In addition, neither the AUC nor the t1/2 of any of these drugs reflected interpatient differences in CD4 lymphocyte counts. Xylose absorption was uniformly low. We did not demonstrate that HIV infection, diarrhea, or CD4 lymphocyte counts contributed significantly to the variability in pharmacokinetics of isoniazid, rifampin, and pyrazinamide in TB patients in Nairobi.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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